A photo of a hand holding a glass of white wine.
Credit: Eileen Davidson

When I was younger, I couldn’t wait to be the legal drinking age. I dreamt of the days when I could casually talk to a stranger at a bar or dance the night away with friends at a club. Once I turned 19 (the legal drinking age in Canada), my social life changed. On weekends, my friends and I would make our way to a bar, club, or tiki lounge and take turns buying rounds. We weren’t picky; beer, wine, bubbly, shots, cocktails — we’d drink them all. Sometimes I’d wake up the next morning with a blurry memory and a splitting headache, which took a day or two to shake off. But soon enough I’d be ready for another night.

It went on like this for years. But eventually, I found myself unable to keep up with the steady stream of booze. Even one drink would make me feel ill. I’d shrug it off, thinking maybe it was a one-time occurrence. I kept going to parties, armed with a few delicious craft beers, hoping that would be the day I could keep up with my friends. But I’d only get through a few sips before the sick feeling set it, forcing me to give away my alcohol and stick with water or coffee.

It wasn’t until I was diagnosed with rheumatoid arthritis, a chronic inflammatory disorder in which your body’s immune system attacks itself, that I realized what may be causing my sudden aversion to alcohol. With time and research, I learned that, for some people with arthritis, drinking alcohol can worsen inflammation, cause nausea, and negatively impact sleep.

I also learned from my rheumatologist that alcohol should be avoided or limited if you are taking certain arthritis medications. For example, methotrexate, which is one of the most effective and widely used medications for treating RA, has been associated with a range of liver-related issues. If you combine that with alcohol, which can also negatively affect the liver, you may increase your risk for liver damage. It’s important to talk to your health care provider about any potential medication side effects, as well as any lifestyle changes — like stopping or cutting back on alcohol — you may need to make while taking any medication.

What Happens When I Drink Alcohol with Rheumatoid Arthritis

After I was diagnosed with rheumatoid arthritis, drinking was no longer enjoyable. I no longer felt the lightness and loss of inhibition that I used to feel when intoxicated; there was no more liquid courage. Instead, it seemed like one sip would send me straight to a hangover, making me more exhausted and heightening the pain I already felt from my rheumatoid arthritis.

I’ve heard friends say passing off a hangover gets harder the older they get, but they haven’t had to pass off a hangover while living with a chronic illness. That is a whole other challenge.

Some people say alcohol helps ease the pain caused by rheumatoid arthritis, but for me, it does the opposite. When I drink even a few sips of alcohol:

  • My legs and arms go heavy
  • My muscles tense up
  • My joint pain intensifies
  • My energy level drops
  • My sleep becomes more fragmented than usual
  • My stomach hurts, often leading to diarrhea
  • My mood swings into a negative space

There are times when I can tolerate a little alcohol. Some days I am lucky enough to enjoy a few drinks as if my life is back to normal. But more often than not, a sip of booze quickly ruins my night and leaves me feeling like I’ve been hit by a truck the following day.

What Happened When I Started Saying No to Alcohol

About a year into my diagnosis, realizing all the cons that accompany drinking with rheumatoid arthritis, I said goodbye to alcohol. I soon learned this would also mean saying goodbye to many of my friends. Or, rather, they said goodbye to me. I was no longer the fun party girl in some of my friends’ eyes, so the invites to clubs and bars stopped coming.

This was hard for a number of reasons. It made me grieve for my pre-chronic illness lifestyle. It made me feel lonely. It made me resent and regret that those so-called friends and I couldn’t find ways to maintain our relationships beyond partying and drinking.

My no-booze lifestyle even made dating more difficult. Guys would ask me to go for a drink, but I’d turn down their invite, leading them to ask why. When they learned it was because I live with a chronic illness, they would move on to another option. Most guys weren’t open to dating a girl who had a chronic illness and didn’t drink; I guess it wasn’t the idea of fun they wanted.

At first I struggled with the loneliness. But eventually I found new ways to occupy my time that didn’t leave me feeling sick. I renewed my love of hiking and found peace in gardening. I focused on my health by researching anti-inflammatory recipes and building up my strength at the gym, a decision that helped me feel more confident in myself. I started learning more about my condition, and eventually became a patient advocate. Over time, I became happy with my new, healthier life.

There was one issue that kept coming up. People got pushy (and sometimes mean) when I refused a drink. Even if I told people “I am on medications that are really unsafe to mix alcohol with” or “Drinking will just make me feel worse,” some people wouldn’t take no for an answer and even go as far as to force drinks on me. I find avoiding those people the best option whenever possible. (If you can’t, take the drink, spill it, and blame it on your sore arthritic hands.)

Introducing Alcohol Back Into My Life

As happy as I was with my new lifestyle, I still went through FOMO (fear of missing out) when I saw “healthy” people enjoying things that I used to love. There were many days where I wanted to fit in with the rest of my peers, and not worry about whether something would cause pain or interfere with my medications. There’s no doubt that living with a chronic illness is overwhelming, but it’s also heartbreaking when you realize how your condition can rob you of simple pleasures. I wanted to be invited to parties and drink like I used to, but I knew deep down I probably wouldn’t feel comfortable.

Eventually, once I felt like I had a better understanding and management of my rheumatoid arthritis, I gradually started to add alcohol back in my life. At first it was only on special occasions or if someone offered me my favorite Sauvignon blanc for free, but eventually I found a way to enjoy my favorite beverages in extreme moderation (and I mean extreme — one to two drinks a month). It turns out moderation is easier and a lot more fun than completely cutting out alcohol.

Another reason I decided to start drinking alcohol again was because I was no longer on methotrexate and my rheumatologist said I had a “perfect liver.”

It hasn’t been a seamless reintroduction. There have been some nights where I pushed myself a little too far. But over time, I’ve developed some tricks that help me drink with rheumatoid arthritis and not feel the negative effects. These include:

  • Drink a lot of water beforehand, and alternate between water and alcohol.
  • Eat food while drinking.
  • Drink in the day, as I’ll likely to have more energy and less pain.
  • Limit myself to three drinks.
  • Listen to my body. If it’s telling me it can’t tolerate alcohol today then I don’t bother.
  • Plan ahead. I always know to arrange a safe ride home, but I also try not to plan anything for the next day in case I overdo it and need the day to sleep things off.

Ultimately, if I know I am unwell, then I know to not have a glass of wine or beer. Just another life lesson my chronic illness taught me.

Want to Get More Involved with Patient Advocacy? 

The 50-State Network is the grassroots advocacy arm of CreakyJoints and the Global Healthy Living Foundation, comprised of patients with chronic illness who are trained as health care activists to proactively connect with local, state, and federal health policy stakeholders to share their perspective and influence change. If you want to effect change and make health care more affordable and accessible to patients with chronic illness, learn more here.

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